Managed Care Business Analyst


A Managed Care Business Analyst is a professional employed by a Healthcare and pharmaceutical organization, who keep track of the reforms, policies and data requirement needs of the stakeholders within the organization and keep track on changes applied to meet the Risk, Analytics, and Reporting needs across various business units. The person will be responsible for requirement gathering, documentations, project management and regulatory changes as key person towards various projects.

Admission Requirements

Recommended: minimum a bachelor’s degree in healthcare business management, Pharmaceutical sciences, Pharmacy, Medical Technology, Public health, Computer Science and Information Technology and Bioinformatics.

Teaching Methodology

Training Delivery Models offered.

Blended Internet Program (BIP).

Pure Internet Program (PIP).

Curriculum Overview

• The course provides a thorough foundation in Healthcare Business Management and Managed Care processes. After going thru the program, the student will be able to perform the following duties.

• The course provides a thorough foundation in Healthcare Business Management and Managed Care processes. After going thru the program, the student will be able to perform the following duties.

• Leads a team of business analysts that support the organization in proactive and retrospective analysis, tracking, research, and problem resolution related to authorizations, utilization management and Clinical Operations.

• Manages the overall program of tools and reports for the Clinical Operations team to assess and track authorization status, workload, turnaround time, pended claims, and other performance metrics.

• Continually assesses and makes recommendations for ways to optimize the service coordination workflows for end to end efficiency and effectiveness.

• Support short and long term operational / strategic business activities by assisting in the development, execution, management and maintenance M&R, CMS Star ratings and coding accuracy improvement strategy and performance.

• Provide analytical support for CMS Star Ratings, HEDIS Measures, and EMR both in an outpatient and inpatient setting.

• Conduct complex analyses (e.g., researches & analyzes policy, techniques & procedures for reconciliation & reimbursement strategies for Medicaid-contracting managed care plans [MCPs] & eligible consumers).

• Monitors & evaluates program policies & procedures to assure compliance with federal & state regulations.

• Provides consultative expertise & training & acts as liaison to both intra-agency & inter-agency providers (e.g., MCPs, enrollment, eligibility, or encounter processing vendors).

• Determines & implements necessary state Benefits eligibility system, Medicaid Information Technology System (MITS) & other programmatic changes & discrepancies.

Use case development, design, and testing; verifies reimbursements request & claims adjustments resulting from eligibility actions. Responsible to investigate, document, and analyze client requirements in project areas such as: new/existing business operating models with innovative approaches to applicable department solutions support, market research of emerging or available product functionality and operational readiness assessment.

The Benefit Student Gains

1) Upgrading the Knowledge required.

2) Better Resume Placement for promising jobs.

3) Low Investment, high learnings

4) Learn from Anywhere, Anytime at your pace.

5) Title Based learning.

Career Pathways

Our objective is to help Experienced Healthcare Business Analyst to meet the following career pathways. Typical Healthcare Business Analyst Job Titles the candidates can apply after this training program are:

Scholarship

Institutional Scholarship is available for selected on tuition. We review your education, certifications, and experiences to evaluate the eligibility and if found qualified an Institutional scholarship will be awarded on Tuition. Email us your resume to check on your eligibility. We will email you the details of the program along with eligible scholarship. Qtech objective is to provide you the right career pathway and advancement required to meet your goals.

Duration - 30 Days / 90 Hours

Post Training Assistance

The Post Training Assistance (PTA) program is provided to candidates who have completed Qtech-Sol Certification training program.


View details

Program Details

Program is designed by industry experts for fresh graduates and professionals. The training provides in depth knowledge of roles and responsibilities of Healthcare Business Analyst.

View details

see what students are saying?


Q-Tech Managed Care Business Analyst Internship program allowed me to gain a deeper knowledge and understanding of the U.S. healthcare system. I feel very well prepared to take enter the healthcare sector with a broad understanding of managed care. The training that I received will be very beneficial to the career that I want to begin. The instructor broke down all of the information in ways that were understandable, and whenever I had question he always made sure that my question was answered accurately.


- Lor Torya Matthews

« A few words
about course »

A Healthcare Business Analyst is a professional employed by a Healthcare and pharmaceutical organization, who keep track of the reforms, policies and data requirement needs of the stakeholders within the organization and keep track on changes applied to meet the Risk, Analytics and Reporting needs across various business units. The person will be responsible for requirement gathering, documentations, project management and regulatory changes as key person towards various projects

Contact us


Qtech Solutions Inc

3 Executive Drive
Suite 320, Somerset
            New Jersey 08873 USA

732-770-4100

 

qpdc@qtech-solutions.com

To Enroll / Enquiry

Your message has been sent. Thank you!